Elder Advocates Of Alberta Society

B.C. man loses right to care for wife

An elderly B.C. man says a provincial health authority stripped him and his wife of their legal and financial rights after he complained bitterly about his wife’s care in the long-term care wing of a local hospital.
â€œShe would have been far better at home,â€ said George Brent, 83, of his wife’s care at the Kootenay Boundary Regional Hospital in Trail, B.C. â€œBut, I’m strapped by legalities set forth by government.â€

Brent’s 81-year-old wife, Dolores, was admitted to the hospital in Trail, which is in southeastern B.C. near the border with Washington state, in August 2009 after suffering a heart attack.

After she recovered, her husband told hospital staff he wanted to take her back to their home in nearby Montrose.

Instead, the hospital moved her into its long-term care wing, saying she was too frail to leave.

â€œShe would ask me every day. ‘When can I get out of here?’â€ said Brent. â€œThey stated that I wouldn’t be allowed to take her home.â€

In the long-term care wing, Dolores Brent’s health deteriorated. She suffered a stroke, and dementia set in.

â€œFor me, that was just another pin in my heart â€” a reminder of my inability to do anything for her,â€ Brent said.

Husband complained repeatedly

Brent and one of his daughters, Gwyn, said they were very upset about what they called the â€œsubstandardâ€ care Dolores Brent received at the Kootenay hospital.

Brent would visit every day, and he and his daughter said they often found Dolores Brent parched, cold, tied to her wheelchair and even sitting in her own waste.

â€œI told the head nurse, and they said, ‘We are too busy to change her’,â€ said Gwyn Brent. â€œSo, they didn’t change her, and she didn’t eat. How can you eat when you are sitting in your own waste? That’s how it is there.â€

â€œIf a child was treated in the same way â€¦ the parents would have the children taken from them,â€ said George Brent.

â€œSixty-four years we have been together. And we fought for each other. To see her mistreated is horrific.â€

George Brent said he complained repeatedly and told staff he still wanted to take his wife home. When the Interior Health Authority, which is responsible for the hospital, began billing him for his wife’s stay in long-term care, Brent decided to protest the standard of care by not paying the bill.

â€œIn a family meeting, [staff] were talking about Dad not paying, and I said ‘Well why don’t I just pay?’ And I was told Dad needed to learn he has to pay his bills,â€ said Gwyn Brent.

Public Guardian steps in

Hospital physicians then assessed Dolores Brent’s deteriorating mental state, and an administrator from the health authority signed a form declaring her incapable of managing her affairs.

The certificate of incapability, as it is known, automatically put B.C.’s Public Guardian and Trustee in charge of her finances instead of her husband even though she had signed an enduring power of attorney appointing George Brent to look after her affairs if she became incapable to do so.

â€œTo get Dolores the support she needs, it is our intention to issue a certificate of incapability,â€ said a letter from the health authority addressed to George Brent in March. â€œThe Public Guardian and Trustee will plan with Dolores to best meet her financial and legal needs.â€

Gwyn Brent says the health officials’ actions were a direct response to her father’s complaints about her mother’s care at the Kootenay hospital.

â€œI think he stepped on too many toes in that place,â€ she said. â€œThey were just fed up with him.â€

The Public Guardian then sent a letter stating, â€œWe have now obtained the authority to act on behalf of Dolores â€¦ Please note that any power of attorney â€¦ is suspended until further notice from this office.â€

Since then, said George Brent, thousands of dollars have been withdrawn from the couple’s joint bank account to pay for Dolores Brent’s care. The province has also staked a claim on the couple’s home and receives the tax bills for the property.

Not ‘something we do lightly’: health authority

In B.C., health authorities were given the power to issue a certificate of incapability and have the Public Guardian suspend an individual’s power of attorney so they could move quickly to protect an elderly person if they suspected a family member was mismanaging or stealing the person’s money.

â€œInvolving the office of the Public Guardian and Trustee isn’t something we do lightly or very often,â€ said Cindy Kozak-Campbell of Interior Health. â€œIt does need to be serious reasons around abuse and neglect and financial issues.â€

Kozak-Campbell said she couldn’t speak directly about the Brent case, because of privacy issues.

â€œWe stay focused on the person in care,â€ she said. â€œSo, although the family may have wishes, it is going to be the safety and comfort of that person in care. And we look for a clean, safe living environment for them.â€

The Brents have nine grown children. Not all of them agreed that their dad should take their mom home from the Kootenay hospital. Shannon Harrigan, a daughter who lives in Oregon, said she voiced her concerns to hospital staff.

â€œNobody wants to see their loved ones in a place like that,â€ said Harrigan, â€œBut, the reason [some of us] wanted to keep her in the hospital was because dad would talk about how if she were at home, they could just die together.

â€œHe couldn’t afford the kind of care she would have needed at home. She needed help to do everything. She would have ended up back in hospital.â€

George Brent still insists he would have taken better care of his wife than the health authority did.

â€œI’m sure I could have,â€ he said. â€œWe had other help that would have come in.â€

He stressed that his wife had appointed him, not their children, to make the decisions on her behalf.

â€œShe is the wife of my youth and the blind passion of my youth,â€ he said tearfully. â€œAnd no hospital and no government can affect that. We will always be together.â€

New laws could have helped couple

Two laws passed in B.C. in 2007 could have given the Brents more rights. The B.C. Ministry of Attorney General said Bill 26 and Bill 29 were passed in a package to give seniors and other vulnerable citizens more say over their health and financial affairs.

However, a spokesperson from the ministry said the implementation of the reforms was put on hold because of the economic downturn.

â€œThat means we’re still stuck with the old archaic laws that George [Brent] has such a problem with,â€ said Laura Watts of the Canadian Centre for Elder Law.

â€œI think a lot of seniors feel like they don’t have enough rights, and I think that’s probably because, mostly, they don’t.â€

Watts said Bill 26 spells out that health care facilities can’t keep someone if they want to go home. If they are deemed incapable, the facility has to get permission from a relative or a legal guardian to keep them in the facility.

She said Bill 29 essentially says a health authority can’t remove a person’s financial or legal rights without getting formal approval from the Public Guardian’s office first. That did not happen in the Brent case. Rather, it was the health authority that launched the process of stripping George Brent of his power of attorney, and the Public Guardian merely signed off on it.

â€œIf these laws aren’t proclaimed, if we leave the legislation the way it is, in my view you are going to see more and more difficult situations, and nobody wins,â€ said Watts.

Ironically, Watts said, other provinces adopted the models set out in the new B.C. laws, but those provinces have gone further and actually put the laws into force.

Ombudsperson dismisses complaint

George Brent filed a complaint with the B.C. Ombudsperson about the standard of his wife’s care but not about his loss of power of attorney.

After looking through health authority records, the Ombudsperson concluded his complaint was not substantiated.

â€œIt appears that [Interior Health Authority] took your concerns seriously,â€ wrote Sandra Chan of the Office of the Ombudsperson. â€œThe documentation â€¦ suggests that IHA provided you with an adequate and appropriate response to the concerns you raised regarding the care provided to your wife.â€

Gwyn Brent remains convinced her father was simply brushed off, because he caused problems for staff in the facility.

â€œWhat a sad world we live in â€” how we treat the elderly,â€ she said. â€œJust because you are elderly, you have no rights anymore? Pretty sad.â€

This summer, Dolores Brent was moved, at the family’s request, to a privately run care home in Trail called Rosewood Village, which has a contract with Interior Health. Her husband said the standard of care there is much higher.

He said he would like to sell their house and move into another part of the same facility to be closer to his wife if and when a room becomes available.

However, he said, since the Public Guardian now has a stake in his home, he may not be allowed to do that.

â€œI’m amazed that I have lived through this year,â€ George Brent said. â€œBecause I get stressed right to the moment of no return, worrying about Dolores and how she is doing.â€